What to expect in the Cardiac examination

A cardiac examination is necessary if you find that you have risk factors to develop heart disease or you have chest pain that could be cardiac related. Doctors and nurses are trained to examine you and know from experience the likely hood of your heart being sick. Even if you are unsure if your pain is cardiac related, why not see your doctor or make a trip to the emergency department. Once there the doctors and nurses will systematically ask you questions and assess you.

There are many aspects to the cardiac examination. Firstly, they will ask you questions called the interview The interview is detailed focused questions designed to narrow down to which system is involved. They will ask you “when did the pain start?”, “where is the pain?” and “what can you do to make it better or worse?” The nurse usually starts the interview, if you find yourself in the emergency department, which is quickly done at triage. When once brought to a room a second nurse will perform a detailed interview going deeper with the questions and finally the doctor will ask again. Although the redundancy may seem annoying especially when you are sick; it is important. When you tell your symptoms over and over you are able to narrow and expertly tell the doctors and nurses what is going on. Every time you tell it, it may change as you think about it more and more.

Secondly, if the nurses and doctors do need to continue to assess your heart based on the answers you provide, they will begin the cardiac physical examination. After undressing into a gown the nurse and/or doctor will look at your chest at the shape and size. Then depending where you are they will start testing with an ECG/EKG (Electrocardiogram) to look at the rhythm of the heart. If nothing there, they will listen to your chest with a stethoscope to listen for your heart sounds (cardiac auscultation) at certain spots on your chest, each spot listens to a different heart valve the test will determine if your heart valves are normal or if you are developing valvular disease.

Thirdly, the nurse and doctor will touch your chest, if your symptoms determine the need. This touching is call palpation. Another test the doctor may perform is tapping on the chest which is called percussion.

Every aspect of the cardiac examination continually narrows down the search of the problem starting wide and continuing to narrow down the problem. In medicine it is based on science, but assessments and figuring out what is wrong is sometimes an art form in itself.

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